Guidelines
391 entriesNDoH Hospital-level adult STG
- Kidney Replacement Therapy (KRT)Description Medicine treatment Description Acute kidney injury (AKI) may affect 60% of ICU patients with up to two-thirds of these patients going on to require kidney replacement therapy (KRT). LoE: IVb xv KRT is commonly used in critically ill patients to achieve solute clearance, maintain acid-base status, and remove fluid excess. Indications for acute Kidney Replacement Therapy (RRT): Stage 3→
- Labour InductionStandard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults, Updated for the 2023 Edition→
- Labour Pain, SevereStandard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults, Updated for the 2023 Edition→
- Leg Ulcers, ComplicatedStandard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2019 Edition→
- Liver Abscess, AmoebicDescription General measures Medicine treatment ICD-10 code: A06.4 DESCRIPTION Focal hepatic infection due to E. histolytica . Only about a third of cases have concomitant amoebic colitis. Diagnosis can be excluded if the serological test is negative. It is essential to exclude pyogenic infection (a diagnostic aspirate should be taken under ultrasound guidance in all cases where there is do→
- Liver Abscess, PyogenicDescription General measures Medicine treatment ICD-10 code: K75.0 DESCRIPTION Focal bacterial infection, usually polymicrobial, of the liver with pus. Multiple abscesses are not uncommon. GENERAL MEASURES Drainage is essential in all cases. This should preferably be done percutaneously by inserting a catheter under ultrasound guidance. MEDICINE TREATMENT Empiric antibiotic therapy Amoxicil→
- Liver Failure, AcuteDescription General Measures Medicine Treatment Referral ICD-10 code: K72.0/K72.9 DESCRIPTION Acute liver failure refers to the development of severe acute liver injury with encephalopathy and impaired synthetic function (INR of ≥1.5) in a patient without cirrhosis or pre-existing liver disease. There are many causes, but the commonest are viral hepatitis, alcohol, drug-induced liver injury→
- Lung AbscessStandard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2019 Edition→
- MalariaMalaria, uncomplicated Malaria, severe See: Primary Health Care STGs and EML - Malaria . MALARIA, UNCOMPLICATED ICD-10 code: B50.0/B50.8-9/B51.0/B51.8-9/B52.9/B53.0/B53.8/B54 *Notifiable medical condition. See: Primary Health Care STGs and EML: Malaria, Non-severe/uncomplicated . MALARIA, SEVERE ICD-10 code: B50.0/B50.8 *Notifiable medical condition. See: Primary Health Ca→
- Male Urethritis Syndrome (MUS)Standard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2019 Edition→
- Malignancies (D49.0-D49.9)Malignancies (D49.0-D49.9)→
- Malodorous Fungating Wounds/TumoursDescription General and supportive measures Medicine treatment DESCRIPTION Non-healing fungating tumours that are often secondarily infected and smelly causing social ostracization and distress to the patient and family. Examples include exophytic retinoblastoma, infected bedsores, rhabdomyosarcoma, osteosarcoma or Kaposi’s sarcoma. GENERAL AND SUPPORTIVE MEASURES Supportive counselling. Set real→
- Management of Selected Antiretroviral Adverse Drug ReactionsPlease click on the link below to access the most up-to-date version of this guideline. The content on this page is currently being updated to align with the latest publication. Always check the version number at the bottom of the screen to confirm which version you are using. Click here to access the Adult Hospital Level Chapter 10: HIV_and_AIDS_with_supporting_NEMLC_Report_Reviews_2025-9-Versio→
- Massive Transfusion ProtocolDescription Major haemorrhage may be defined as blood loss >150 ml/min, loss of >50% of blood volume in 3 hours, or loss of entire blood volume in 24 hours. A massive transfusion may also be defined by the transfusion of >4 units of red blood cells in 1 hour, replacement of >50% of blood volume in 3 hours (>5 units in 3 hours), or the replacement of entire blood volume in 24 hours→
- MastoiditisStandard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2019 Edition→
- Medical EmergenciesStandard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2019 Edition→
- Medical Management of Ectopic PregnancyGeneral measures Medicine treatment Referral ICD-10 code: O00.0-2/O00.8-9 GENERAL MEASURES Ruptured or suspected rupture of an ectopic pregnancy should be managed with urgent resuscitation and surgery. There must be certainty that there is no viable intra-uterine pregnancy. The discriminatory zone is the β-hCG level above which an ultrasound is likely to visualise a gestational sac within t→
- Medical Management of Eye InjuryStandard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2019 Edition→
- Medicines in PregnancyStandard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2019 Edition→
- Medicines to Treat Complications of AnaesthesiaStandard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2019 Edition→
- Menopause and Perimenopausal SyndromeReferral ICD-10 code: N95.0-3/N95.8-9 For primary management with hormone therapy (HT), refer to the PHC STGs and EML, Hormone therapy (HT) . If HT is contra-indicated, poorly tolerated or ineffective: Fluoxetine, oral Initiate at 20 mg on alternate days. If there is no response after 12 weeks, increase the dose to 20 mg daily. LoE:IIIb xxxix If on tamoxifen: Citalopram, oral, 10 mg d→
- Mental Health ConditionsPrecepts of the Mental Health Care Act No. 17 of 2002 include: All patients with mental illness and/or severe to profound intellectual disability should receive mental health care as either Voluntary, Assisted or Involuntary Mental Health Care Users. All registered medical practitioners, professional nurses, psychologists, occupational therapists (OTs), and social workers whose training includes→
- Mental Health Conditions and Substance Misuse NEMLC Recommendations for Medicine Amendments (2020-2023 Review Cycle)South African Adult Hospital Level Essential Medicine List. Medicine amendment recommendations, with supporting evidence and rationale are listed below. Kindly review the medicine amendments in the context of the respective standard treatment guideline (STG). Click here for the Mental health conditions and substance misuse NEMLC Recommendations for medicine amendments (2020-2023 Review Cycl→
- Metabolic EmergenciesStandard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2019 Edition→
- Metabolic and Endocrine SupportThyroid disorders in critically ill patients Sick Euthyroid Syndrome Hyperthyroidism Thyroid crisis Hypothyroidism Thyroid Disorders in Critically ill Patients Description Non-specific alterations can occur in critically ill patients. The majority revert to normality upon full recovery from the underlying physical insult. The transient dysfunction is attributed to changes in thyroid stimulating h→
- MiscarriageSilent miscarriage or early fetal death Incomplete miscarriage in the first trimester Midtrimester miscarriage (from 13-22 weeks gestation) Septic miscarriage Trophoblastic neoplasia Both manual vacuum aspiration (MVA) and medical evacuation are equally effective for miscarriage. However, MVA is preferred in the follow settings: anaemia haemodynamic instability second trimester miscarriage SILENT→
- Movement DisordersStandard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2019 Edition→
- Multiple SclerosisStandard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2019 Edition→
- Muscle RelaxantsStandard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2019 Edition→
- Myasthenia GravisStandard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2019 Edition→
- Myelodysplastic SyndromesDescription General Measures Referral D46.0-7/D46.9 DESCRIPTION A group of disorders characterised by refractory cytopaenias due to bone marrow failure. There is a risk of disease progression to acute leukaemia. Investigations Evidence of cytopenia, with normal B 12 and folate levels, and often substantial morphological dysplasia on the blood smear. Bone marrow examination confirms dysplasia of t→
- Myelopathy, AcuteStandard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2019 Edition→
- Myxoedema ComaDescription General Measures Medicine Treatment ICD-10 code: E03.5/E03.9 Description Myxoedema coma is an uncommon condition characterized by severe hypothyroidism which may present with an altered mental status, lethargy, hypothermia, decreased organ function, and other non-specific features associated with hypothyroidism. Myxoedema coma is a life-threatening condition with a high mortalit→
- Nephrology Disorders, IntroductionStandard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2019 Edition→
- Nephrotic SyndromeStandard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2019 Edition→
- Neuro-Psychological SupportDescription Pain Management Mood Disorders Seizures Intracranial Pressure Management Description ICU patients are treated with many interventions that may be distressing and uncomfortable. Pain, restlessness, agitation, and delirium may have untoward effects. LoE:IVb xxviii Pain Management ICD-10 code: R52 Description Prioritization of effective pain control is imperative for optimising the care→
- NeuropathyStandard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2019 Edition→
- Neuropsychiatric ConditionsStandard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2019 Edition→
- Obstructive ShockDescription Treatment ICD-10 code: R57.8 DESCRIPTION Occurs when there is an obstruction to the filling of the right ventricle or an obstruction in blood flow. Clinical signs include hypotension, tachycardia, cold peripheries and distended neck veins. Causes include: cardiac tamponade, tension pneumothorax, acute pulmonary embolism, and severe bronchospasm. TREATMENT Treat the cause. Acute pulmon→
- Oedema, CerebralStandard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2019 Edition→
- Opportunistic DiseasesPlease click on the link below to access the most up-to-date version of this guideline. The content on this page is currently being updated to align with the latest publication. Always check the version number at the bottom of the screen to confirm which version you are using. Click here to access the Adult Hospital Level Chapter 10: HIV_and_AIDS_with_supporting_NEMLC_Report_Reviews_2025-9-Versio→
- OsteoarthritisStandard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2019 Edition→
- Osteomalacia/RicketsStandard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2019 Edition→
- OsteoporosisStandard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2019 Edition→
- Otitis ExternaStandard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2019 Edition→
- Otitis Media, AcuteStandard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2019 Edition→
- Otitis Media, Chronic, SuppurativeStandard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2019 Edition→
- Overactive BladderStandard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2019 Edition→
- Paget's DiseaseStandard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2019 Edition→
- PainStandard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Adults 2019 Edition→